title: Breast cancer survivors' beliefs about the causes of breast cancer.
abstract: OBJECTIVE
  To explore the beliefs held by breast cancer (BC) survivors about the factors that contribute to the development of their BC.
  
  
  METHODS
  The BUPA Health Foundation Health and Well-being after Breast Cancer Study is a prospective cohort study of 1684 women recruited within 12 months of their first diagnosis with invasive BC. Participants completed an enrollment questionnaire (EQ), first follow-up questionnaire (FQ1) and a second follow-up questionnaire (FQ2), 12 months and 24 months post-EQ, respectively. In the FQ2, women were asked whether they believed anything contributed to the development of their BC and whether they had made lifestyle changes since the FQ1. Well-being was assessed at the FQ2 using the psychological general well-being index (PGWB).
  
  
  RESULTS
  In total, 1496/1684 women completed the FQ2 and 43.5% reported belief in a factor that may have contributed to their developing BC. These women were more likely to be younger (p<0.0001) and educated beyond high school (p<0.0001). Stress (58.1%) was the most common reason given, followed by previous use of hormone therapy (17.0%) and a family history of any cancer (9.8%). Women who believed stress contributed to their BC had lower PGWB scores than other study participants (70.9 ± 16.1, n = 361 versus 77.3 ± 14.9, n = 1071, mean difference = 6.4, 95% CI: 4.6-8.2 p<0.0001) and were more likely to have made lifestyle changes since their BC diagnosis.
  
  
  CONCLUSIONS
  Many women with BC believe that stress has contributed to their condition. Women who held this belief were more likely to adopt strategies to reduce stress than those who did not.
authors.affiliation: Women's Health Research Program, Monash University, Melbourne, VIC, Australia. mary.panjari@monash.edu
authors.forename: Mary
authors.initials: M
authors.lastname: Panjari
authors.forename: Susan R
authors.initials: SR
authors.lastname: Davis
authors.forename: Pamela
authors.initials: P
authors.lastname: Fradkin
authors.forename: Robin J
authors.initials: RJ
authors.lastname: Bell
mesh_terms: D000328:Adult; D017677:Age Distribution; D000368:Aged; D001315:Australia; D001943:Breast Neoplasms / Q000175:diagnosis / Q000209:etiology / Q000523:psychology*; D005260:Female; D005500:Follow-Up Studies; D015438:Health Behavior; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008875:Middle Aged; D011446:Prospective Studies; D012307:Risk Factors; D012959:Socioeconomic Factors; D013315:Stress, Psychological; D011795:Surveys and Questionnaires; D017741:Survivors / Q000523:psychology*